Biomedical Engineering Reference
In-Depth Information
we could not proliferate from trying to explain, and especially understand,
what kind of mélange a depression or an anxiety disorder is, and what it
is that distinguishes them from normal conditions of life. Phenomenology
could help us in this task, by offering a kind of understanding that is not
preconditioned by scientifi c models of the psyche, neither of psychoanalytic
nor of biological heritage. In the phenomenological attitude, we abstain
from theoretical prejudgments and study the way phenomena appear from
the fi rst-person perspective. We study their structure of meaning, not the
causes behind them.
Which kind of phenomena we should concentrate upon in the case of
depression and anxiety disorders is pretty clear from the lists of criteria
given in DSM-IV - the central roles in the diagnostic patterns are played
by painful feelings, problems with engagement in the world, and altered
embodiment. If we could fi nd a way of understanding how these three
types of phenomena are related to each other in everyday life, we would
have gained much in our attempts to analyze the SSRI revolution. If we, by
the same phenomenological analysis, could offer a way to understand the
difference between normal and abnormal (meaning healthy and ill) ways
of being attuned, world-engaged and embodied, we would have come even
further. And if we, fi nally, by way of the analysis, were able to offer a more
extended account of the relation between the
normal
and the
normative
in the sphere of feelings, world-engagement and embodiment - including
social processes, patterns of self formation and matters pertaining to the
good life - we would certainly gain a rather comprehensive, if not complete,
understanding of the SSRI revolution. I will not be able to carry out all these
three missions in this chapter, but I will try to make a good start.
Being attuned and being-in-the-world
The three basic feelings which are characteristic of anxiety disorders and
depression are, I would say,
anxiety
,
boredom
and
grief
. It is clear from the
lists of criteria in DSM-IV stated above that one could certainly choose to
give these feelings slightly different names and thereby slightly different
meanings. In the case of grief, we could choose to speak about sorrow,
sadness, guilt, or loss, for instance. I will try to handle this dilemma in my
attempts to draw a line between normal grief and depression below. In
specifying the differences between normal anxiousness and boredom, on the
one hand, and the pathological forms of these phenomena, on the other, a
similar discussion will occur.
It might seem from the diagnostic patterns dealt with above that anxiety
disorders and depressive disorders are rather different. One should not
forget, however, that anxiousness and panic attacks are common features
of depression, and that people who suffer from anxiety disorders often are
depressed as well. The fact that SSRIs appear to have good effects on both
kinds of disorders could be taken to indicate that the disorders are best
